title: Meningococcal disease and the complement system.
abstract: Despite considerable advances in the understanding of the pathogenesis of meningococcal disease, this infection remains a major cause of morbidity and mortality globally. The role of the complement system in innate immune defenses against invasive meningococcal disease is well established. Individuals deficient in components of the alternative and terminal complement pathways are highly predisposed to invasive, often recurrent meningococcal infections. Genome-wide analysis studies also point to a central role for complement in disease pathogenesis. Here we review the pathophysiologic events pertinent to the complement system that accompany meningococcal sepsis in humans. Meningococci use several often redundant mechanisms to evade killing by human complement. Capsular polysaccharide and lipooligosaccharide glycan composition play critical roles in complement evasion. Some of the newly described protein vaccine antigens interact with complement components and have sparked considerable research interest.
authors.affiliation: Division of Infectious Diseases and Immunology; University of Massachusetts Medical School; Worcester, MA USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Lewis
authors.affiliation: Division of Infectious Diseases and Immunology; University of Massachusetts Medical School; Worcester, MA USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Ram
mesh_terms: D000907:Antibodies, Bacterial / Q000276:immunology*; D000942:Antigens, Bacterial / Q000276:immunology; D016667:Bacterial Capsules / Q000276:immunology; D003167:Complement Activation / Q000276:immunology*; D050716:Complement C4b-Binding Protein / Q000276:immunology; D017242:Complement Factor H / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D008070:Lipopolysaccharides / Q000276:immunology; D008589:Meningococcal Infections / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality; D009345:Neisseria meningitidis / Q000276:immunology; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D019096:Vitronectin / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D050716:Complement C4b-Binding Protein; D008070:Lipopolysaccharides; D019096:Vitronectin; C023023:lipid-linked oligosaccharides; D017242:Complement Factor H
keywords: Neisseria meningitidis; complement; complement deficiency; meningococcus; sepsis